HIV-positive mothers and children affected by HIV and AIDS receive care and support at PMTCT sites

HIV-Positive mothers with their children receive care and support at the Health Centre in Xai-Xai City. The Health Centre provides HIV testing and counselling, PMTCT services and anti-retroviral treatment for infected mothers and children.

Xai-Xai, Gaza Province, April 2008 – Like any other Wednesday morning, 30 year old Telzira has come to the Health Centre in Xai-Xai city with her 8 month old daughter. She has brought her for the Consultation for Children at Risk, and has also come to meet with the group of HIV-positive pregnant women and mothers who gather at the Health Centre once a week.

This group, guided by nurses of the maternal and child health services, has helped Telzira to adhere to her anti-retroviral treatment and to care adequately for her daughter, so that she can survive and and develop healthy. The comfort and support received from other HIV positive women helped Telzira face the future with hope.

“I took the HIV test when I was pregnant. It was positive. I began to take the drugs then, and so I’m continuing to live like a normal person”, says Telzira, as she strokes her little girl, sleeping peacefully on her breast.

“I like to come here because I am well received and treated well. In the group we speak about our difficulties, we learn how to prepare nutritious food, and we receive advice about health care”, Telzira explains.

The promotion of mutual support and counselling groups in the health centres is one of the strategies that the health authorities have undertaken to encourage HIV-positive pregnant women to join the programme for preventing the mother-to-child transmission of HIV (PMTCT).

This strategy also tries to encourage HIV-positive mothers to continue anti-retroviral treatment and to bring their children who have been exposed to or infected by HIV for follow-up. Some of the women in the support group are trained as activists to mobilise others in the same condition.

HIV-positive Mothers Groups are an important source of support for HIV-positive pregnant women.

“We set up these groups because we noticed that initially many of the HIV-positive mothers stopped coming with their children after giving birth, arguing that their children were not ill”, explains the Xai-Xai City Health Director, Dr Adalgisa Viola. “But now the situation is improving. Currently we have about 580 children with HIV-positive mothers attending the Consultations for Children at Risk”.

UNICEF began to support the establishment of PMTCT sites in Mozambican health units in 2002. Around 386 health units – about half the total number of health units in the country – were offering these services at the end of 2007 and the number is fast increasing.

In the Xai-Xai Health Centre, for example, where the PMTCT programme began in October 2004, with the support of UNICEF and other partners, all the nurses linked to maternal and child health are trained on HIV and AIDS. Thus, as part of the routine ante-natal consultations, HIV testing and counselling, PMTCT services and anti-retroviral treatment for infected mothers and children are also offered.

The PMTCT programme includes outreach activities in the communities. As Adalgisa Viola explains, when the PMTCT services were set up, few women agreed to take the HIV test or even to go to follow-up consultations when they tested HIV-positive. This situation was of great concern to the health authorities in Gaza province, where the HIV prevalence rate is currently estimated at 27 per cent, the highest rate among all the provinces in Mozambique.

In response, the Gaza health authorities have been involving the traditional birth attendants, the traditional medicine practicioners, and neighbourhood and community leaders. They are trained to advise mothers and pregnant women on the importance of taking the HIV test, of joining the PMTCT and anti-retroviral treatment programmes, should the test prove positive, and of bringing the child for follow-up.

“Of the 3,520 pregnant women who took the test last year, 913 were positive, and they are all now in the PMTCT programme”, says Adalgisa Viola, showing the progress that has been made with this intervention in the Xai-Xai City Health Centre.

In addition, this health centre recently introduced PCR (Polymerase Chain Reaction), a test that can detect the presence of the HIV virus in children under 18 months old.

“Of the 156 children already tested, 132 were HIV-negative, thanks to the PMTCT programme under way here”, concludes Adalgisa Viola.

In 2007, it was estimated that the HIV prevalence rate among pregnant women in Mozambique was 16 per cent. The expansion of PMTCT sites and the involvement of communities in implementation are fundamental to reverse the spread of HIV, and mitigate the impact of the pandemic in the country, particularly among women and children.